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Associating Disseminated Intravascular Coagulation with Clinical and Laboratory Evaluations of Pediatric Patients with Acute Gastroenteritis admitted at Gharyan Central and Teaching Hospital, Libya 利比亚Gharyan中央和教学医院收治的急性胃肠炎患儿弥散性血管内凝血与临床和实验室评估的关联
Pub Date : 2017-11-06 DOI: 10.4172/2329-9126-C1-005
H. Schutze, M. Chin, D. Weller, Sue Suchy, M. Harris
Globally, acute gastroenteritis is an ailment that is very common among children during their first 3 years of life at which they will most likely experience about 1 to 3 acute diarrheal illnesses that can generate complication such as dehydration and disseminated intravascular coagulation. The diagnosis itself and its accompanying complications can be easily identified though proper clinical and laboratory evaluation. The purpose of this study was to identify evidences of disseminated intravascular coagulation (DIC) and correlate with other clinical or laboratory tests related to other complications of acute gastroenteritis (AGE) such as dehydration and some metabolic imbalances. Almost all of pediatrics patient who are severely dehydrated, suffering from hypernatremia and with hyperammonemia are with evidences of DIC. Moreover, some of the variables found to be significantly associated with positive and strong relationship while some are not.
在全球范围内,急性胃肠炎是一种非常常见的儿童疾病,在他们生命的头3年里,他们很可能会经历大约1至3种急性腹泻疾病,这些疾病可能产生脱水和弥散性血管内凝血等并发症。通过适当的临床和实验室评估,诊断本身及其伴随的并发症很容易识别。本研究的目的是确定弥散性血管内凝血(DIC)的证据,并与其他与急性胃肠炎(AGE)并发症(如脱水和一些代谢失衡)相关的临床或实验室检查相关联。严重脱水、高钠血症和高氨血症患儿几乎都有DIC的证据。此外,一些变量被发现与积极和强烈的关系显著相关,而另一些则不是。
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引用次数: 0
Eagle’s Syndrome - View from the General Practitioners Perspective 鹰氏综合症-从全科医生的角度看
Pub Date : 2014-02-01 DOI: 10.5923/J.CMD.20140401.02
D. Chickooree, V. Ram
Eagle's syndrome, the famous discovery of W. Eagle, is associated with repeated episodes of pain on rotating the neck, dysphagia and referred otalgia due to elongation of styloid process or ossified stylohyoid. Familiarity with Eagle's syndrome shows that its symptoms can be easily confused with other craniomandibular diseases. Since it is a rare clinical entity, its diagnosis is often hard to make, especially in the absence of sound clinical knowledge and good radiographs. Depending on the position of styloid process in relation to underlying anatomical structures, symptoms vary considerably, and in severe cases continuous compression of the carotid artery can lead to stroke and even death. The treatment of choice is mainly styloidectomy; however some conservative treatment is still being practiced. Very few studies have been reported in the literature classifying the elongation and calcification patterns of styloid process. In this review we aim to spread light on the epidemiology, clinical manifestation, diagnosis, and therapy for Eagle's syndrome and also target to help the general practitioner in differential diagnosis with other conditions that can provide similar signs and symptoms.
Eagle综合征是W. Eagle的著名发现,与反复发作的颈部旋转疼痛、吞咽困难和由茎突延长或茎突舌骨骨化引起的耳痛有关。对鹰氏综合征的熟悉表明,其症状很容易与其他颅下颌疾病混淆。由于它是一种罕见的临床实体,它的诊断往往很难做出,特别是在缺乏良好的临床知识和良好的x线片。茎突相对于底层解剖结构的位置不同,症状也有很大差异,在严重的情况下,持续压迫颈动脉可导致中风甚至死亡。治疗选择以茎突切除术为主;然而,一些保守治疗仍在实行。文献中对茎突的伸长和钙化模式进行分类的研究很少。在这篇综述中,我们的目的是传播关于鹰氏综合征的流行病学、临床表现、诊断和治疗,并旨在帮助全科医生鉴别诊断其他可能出现类似体征和症状的疾病。
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引用次数: 10
Insulin Autoimmune Syndrome (Hirata Disease): Case Report in a Caucasian Patient with New-Onset Diabetes 胰岛素自身免疫综合征(平田病):1例新发糖尿病白人患者
Pub Date : 2012-12-01 DOI: 10.5923/J.CMD.20120205.02
M. Sudano, F. Turchi, P. Sossai
An unusual cause of spontaneous hypoglycemia is Insulin Autoimmune Syndrome (or Hirata Disease), characterized by high levels of insulinemia and circulating autoantibodies to insulin in subjects without prior insulin administration. In Western Countries less than 70 cases have been published so far. Here we report a case where IAS was the prodromical stage of new onset type 1 diabetes. HLA typing in IAS was rarely reported in Western cases, here we also discuss the peculiar HLA pattern of our patient.
自发性低血糖的一个不寻常的原因是胰岛素自身免疫性综合征(或平田病),其特征是在没有胰岛素治疗的受试者中存在高水平的胰岛素血症和循环中的胰岛素自身抗体。在西方国家,迄今已公布的病例不到70例。在这里,我们报告一个病例,IAS是新发1型糖尿病的前驱期。HLA分型在西方病例中很少报道,这里我们也讨论了我们患者的特殊HLA分型。
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引用次数: 4
Differential Staged Sacral Reflexes: Methodology and Normal Values from 51 Healthy Subjects and 134 Patients with Pudendal Neuralgia 不同阶段的骶骨反射:51名健康受试者和134名阴部神经痛患者的方法和正常值
Pub Date : 2012-12-01 DOI: 10.5923/J.CMD.20120204.01
E. Bisschop, R. Nundlall
Objective : to develop a reproducible method for electrophysiological study of pudendal nerves which can explore the different risk areas: sacral spinal, infrap iriformis area and ischiorectal fossa. This method is called "differential staged sacral reflexes (DSSR) ". 51 patients not suffering fro m pudendal neuralgia and 134 patients with pudendal neuralgia have been selected. The sacral reflexes (SR) are made at the ventral and dorsal quadrants of the anal sphincter and at the pubococcygeus muscle. Considering the values of the DSSR obtained on healthy subjects and on patients with pudendal neuralgia, maximu m threshold values have been established: a significant difference between ventral and dorsal quadrant of the anal sphincter: damage orientation at the level of the ischiorectal fossa; significant difference between dorsal quadrant of the anal sphincter and pubococcygeus muscle: damage orientation at the level of the infrapiriformis area. SR delayed uniformly at the three afore-mentioned muscles: damage orientation at the level of the sacral spinal. The DSSR allow in a reproducible way to investigate the pudendal nerve in all areas suitable to entrap this nerve, which is impossible with the method of pudendal nerve terminal motor latency (PNTM L).
目的:建立一种可重复的阴部神经电生理研究方法,以探索不同的危险区域:骶脊髓、虹膜下区和坐骨直肠窝。这种方法被称为“不同阶段的骶骨反射(DSSR)”。”。选取51例无阴部神经痛患者和134例阴部神经痛患者。骶反射(SR)发生在肛门括约肌的腹、背象限和耻骨尾骨肌。考虑健康受试者和阴部神经痛患者的DSSR值,建立了最大阈值:肛门括约肌腹侧和背侧有显著差异;坐骨直肠窝水平的损伤方向;肛门括约肌背象限与耻骨尾骨肌背象限的显著差异:梨状下肌水平损伤方向。SR在上述三块肌肉均匀延迟:骶脊髓水平的损伤方向。DSSR允许以一种可重复的方式调查阴部神经在所有适合捕获该神经的区域,这是阴部神经末梢运动潜伏期(PNTM L)方法所不可能的。
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引用次数: 0
An Unusual Presentation of Coronary Artery Fistula in Athlete - Case Report 运动员冠状动脉瘘的一种不寻常表现-病例报告
Pub Date : 2012-12-01 DOI: 10.5923/J.CMD.20120204.03
A. Kiško, Ľ. Derňárová, J. Kmec, M. Vereb, A. Hudáková, M. Jakubikova, N. Kishko
A 32-year-old active cyclist was referred fo r the evaluation because of syncope he had performed in preseason. He was found to be normostenic, acyanotic, normotensive with clear lungs and a regular pulse of 60 bp m, with normal dual heart sounds and a grade Levine 2/6 continuous diastolic murmu r in the second intercostal space of the left parasternal area. He had no family history of premature card iac death and his lipids were normal. Rest ECG showed a regular sinus rhythm of 62 bp m with inco mplete right bundle branch block and no significant ST-T changes. A transthoracic ECHO in parasternal short-axis view revealed an anomalous colour flow jet in diastole arising fro m the lateral wall into the main pulmonary artery and coronary artery fistula with non-significant left -to-right shunt (Qp/Qs ratio 1.2).came under suspicion. In contrast, it has not been confirmed clearly by the transoesophageal ECHO. Coronary angiography was without coronary stenosis and confirmed a 'serpentine' anomalous drainage supposedly from left anterior descending artery to the main pulmonary artery. A complex anato my of sacculary dilated fistula that originates fro m the pro ximal left anterio r descending artery and drainages the main pulmonary artery was showed in detail by a 64 slice MDCT scanning. Myocardial Tc-99m Myoview perfusion SPECT imag ing showed no perfusion defects in maximal physical stress and follo w-up without intervention was suggested. In addition, due to the results of holter ECG monitoring, head-up tilt testing, carotid sinus massage and programmed atrial stimulat ion syncope was concluded as vasovagal, but its nature still remains discussible. After a three year follow-up patient remains asympto matic and recently performed control myocardial perfusion SPECT showed no signs of stress related myo cardial ischemia. In conclusion, several imaging techniques are needed for an accurate diagnosis of coronary fistula and for the suggestion of proper further management. In some cases syncope may be the first man ifestation of CAF, but it is still unclear if it is directly related to the coronary anomaly.
一名32岁的活跃自行车运动员在季前赛中因晕厥而接受评估。患者血压正常,无脏水,肺清晰,脉搏正常,60 bp m,双心音正常,左胸骨旁第二肋间隙连续舒张性杂音2/6级。无早死家族史,血脂正常。静息心电图显示正常窦性心律62 bp m,右束支阻滞不完全,ST-T无明显改变。经胸胸骨旁短轴位回声显示舒张期异常彩色血流射流,由侧壁进入肺动脉主动脉和冠状动脉瘘,无明显左向右分流(Qp/Qs比1.2)。受到怀疑。相比之下,经食管回声并没有明确证实。冠状动脉造影未见冠状动脉狭窄,并证实从左前降支到肺动脉主动脉有“蛇形”异常引流。64层多层螺旋ct扫描显示了一个复杂的囊状扩张瘘,起源于左前降支前段,并以肺动脉为主引流。心肌Tc-99m Myoview灌注SPECT显像显示最大生理应激无灌注缺损,建议不干预随访。此外,根据动态心电图监测、平头倾斜试验、颈动脉窦按摩和程序性心房刺激的结果,晕厥被推断为血管迷走神经性,但其性质仍有争议。经过三年的随访,患者无症状,最近进行的对照心肌灌注SPECT显示没有应激相关心肌缺血的迹象。总之,需要多种影像学技术来准确诊断冠状动脉瘘并建议适当的进一步治疗。在某些情况下,晕厥可能是CAF的第一个男性表现,但尚不清楚它是否与冠状动脉异常直接相关。
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引用次数: 1
Factors Affecting Antihypertensive Treatment Adherence: A Saudi Arabian Perspective
Pub Date : 2012-12-01 DOI: 10.5923/j.cmd.20120204.02
F. Alsolami, X. Hou, I. Correa-Velez
Hypertension is a global health issue among the adult population. Adherence to antihypertensive medications is an effective step for better control of blood pressure and preventing the risk of complications. Several factors support or hinder hypertensive patients’ adherence. Objectives: This article reviews the factors affecting adherence to antihypertensive treatments, and reflects on these factors from a Saudi Arabian perspective. Methods: Papers and studies about antihypertensive medication adherence were reviewed from different databases including MEDLINE, PubMed, ScienceDirect and Google scholar. Results: Factors affecting antihypertensive treatments adherence are classified into three domains: Patient (e.g. sociodemographic, individual knowledge and skills), Health System, and Provider related factors.
高血压是成年人中一个全球性的健康问题。坚持服用降压药是更好地控制血压和预防并发症风险的有效步骤。一些因素支持或阻碍高血压患者的依从性。目的:本文综述了影响降压治疗依从性的因素,并从沙特阿拉伯的角度对这些因素进行了反思。方法:对MEDLINE、PubMed、ScienceDirect、Google scholar等数据库中有关抗高血压药物依从性的论文和研究进行回顾性分析。结果:影响降压治疗依从性的因素分为三个领域:患者(如社会人口学、个人知识和技能)、卫生系统和提供者相关因素。
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引用次数: 29
Parvovirus B19: Evaluation of Incidence, Prevalence and Risk Factors among Pregnant Women Attending Ante-Natal Clinic in Nasarawa State, North Central of Nigeria 细小病毒B19:尼日利亚中北部纳萨拉瓦州产前门诊孕妇发病率、流行率和危险因素评估
Pub Date : 2012-12-01 DOI: 10.5923/J.CMD.20120205.03
Akyala Ishaku. A, A. E. U., A. zua A. T, Agieni Ashem Godwin
Trans-placental transmission of parvovirus B19 during pregnancy has been reported as one of the leading causes of non-immune fetal hydrops, spontaneous abortion or intra-uterine fetal death. We therefore set out to determine the presence of parvovirus B19 (Ig G and IgM) antibodies and their risk factors among pregnant wo men attending ante-natal clin ic, at Federal Medical Center, Keffi, Nasarawa State, Nigeria.A total of 273 pregnant women (Age range 15-40 years) participated after informed consent and clearance fro m the research ethics committee. Each filled a self-ad ministered questionnaire and donated blood samples between January and August 2012. A reco mbinant parvovirus B19 IgM and Ig G ELISA kit fro m DeMediTec (USA) was used for the assays.Of the 273 participants, 36 (13.2 %) had IgM antibodies, while 75 (27.5%) had Ig G antibodies with those aged 15-20 and 36-40 years having the highest incidence and prevalence rates. Being a house wife, having more ch ild ren and histories of blood transfusion, miscarriage and still b irth were associated with infection (P < 0.05).The study reveals high incidence and prevalence of parvovirus B19 infect ion among the pregnant women. The presence of parvovirus B19 IgM antibody particularly in the first and second trimesters of pregnancy poses the danger of likely trans placental transmission leading to spontaneous abortion and intra-uterine fetal death.
据报道,怀孕期间细小病毒B19经胎盘传播是导致非免疫性胎儿水肿、自然流产或子宫内胎儿死亡的主要原因之一。因此,我们着手确定在尼日利亚纳萨拉瓦州凯菲联邦医疗中心产前诊所就诊的两名孕妇中细小病毒B19 (igg和IgM)抗体的存在及其危险因素。经知情同意并获得研究伦理委员会批准,共有273名孕妇(年龄15-40岁)参与研究。在2012年1月至8月期间,每个人都填写了一份自我管理的问卷,并捐献了血液样本。采用美国DeMediTec公司重组细小病毒B19 IgM和Ig G酶联免疫吸附测定试剂盒。在273名参与者中,36人(13.2%)有IgM抗体,75人(27.5%)有Ig G抗体,其中15-20岁和36-40岁的发病率和患病率最高。家庭主妇、多子女、输血史、流产史、死产史与感染相关(P < 0.05)。本研究揭示了细小病毒B19感染在孕妇中的高发和流行。细小病毒B19 IgM抗体的存在,特别是在妊娠的前三个月和中期,有可能经胎盘传播导致自然流产和子宫内胎儿死亡的危险。
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引用次数: 4
Numerical Chromosomal Abnormalities in Patients with Acute Lymphoblastic and Myeloid Leukemia in Iran 伊朗急性淋巴母细胞和髓性白血病患者的数字染色体异常
Pub Date : 2012-12-01 DOI: 10.5923/J.CMD.20120205.01
A. Malekasgar, M. Pedram, Sayyed kamal Eshagh housaini
The majority of cases of ALL demonstrate an abnormal karyotype, either in chro mosome nu mber or structural changes. Abnormal chro mosome number in childhood acute lymphoblastic leukemia defines distinct biological subgroups with a different response to treatment. The tubes are cultured with three different protocols to save time if one protocol failed. Cultures are then harvested, and cells are fixed and chromosome spreads are prepared. Of 25 patient studied, one patient had psudodiploid karyotype, three patients had tetra-ploid karyotype, four patients had low hypo-diploid karyotype, four patients had high hyper-diploid karyotype, five patients had low hyper-d iploid karyotype and eight patients had normal karyotype. Some other factors like, Age, Sex, Consanguinity, Hemoglob in, W BC count, and Type of the leukemia cell also have been evaluated. We found excess number of patients having hypodiploid karyotype but still response to treatment protocols were satisfactory. By co mparison between 4 different cultures methods, we find d irect method to be more efficient for ploidy analysis.
大多数ALL病例表现为染色体数目或结构改变的异常核型。儿童急性淋巴细胞白血病的染色体数目异常定义了不同的生物学亚群,对治疗的反应不同。试管用三种不同的方法培养,以便在一种方法失败时节省时间。然后收获培养物,固定细胞,准备染色体扩散。25例患者中,1例为伪二倍体核型,3例为四倍体核型,4例为低次二倍体核型,4例为高超二倍体核型,5例为低超d二倍体核型,8例为正常核型。其他一些因素,如年龄、性别、血亲、血红蛋白、白细胞计数和白血病细胞类型也进行了评估。我们发现有大量的患者具有次二倍体核型,但对治疗方案的反应仍然令人满意。通过4种不同培养方法的比较,我们发现直接培养法对倍性分析更有效。
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引用次数: 1
Comparison of Exercise Open Kinetic Chain and Closed Kinetic Chain in The Rehabilitation of Patellofemoral Dysfunction: an Updated Revision 开放式运动链与封闭式运动链在髌股功能障碍康复中的比较:最新修订
Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20120203.01
Thatiana Lacerda Nobre
Introduction: The patellofemoral syndrome (PDS) is a disease characterized by pain in the patellofemoral l and physical changes resulting from this joint biomechanics. The rate of incidence is high and its etiology remains unknown. Objective: This literature review aims to compare the effectiveness of open kinetic chain exercises with closed kinetic chain into the functional recovery of patients with the patella-femoral syndrome. Methods: We conducted a systematic review in the database LILACS, MEDLINE and PUB MED SCIELO as search term words patellofemoral syndrome, Open Kinetic Chain and Closed Kinetic Chain. Discussion: The imbalance of forces of patella dynamic stabilizers, Vastus medialis oblique (VMO) and vastus lateralis (VL), is still considered the primary factor for the onset of symptoms. Since this change causes an increase in reaction force and patellofemoral compression. In order to recover the balance of forces of the muscles acting as stabilizers of the knee and as a means of restoring stability to the joint, exercises in open kinetic chain (OKC) and closed kinetic chain (CKC) has been used in rehabilitation programs patellofemoral disorders. Conclusion: The benefits for implementing these protocols are not well documented; scientific evidences are insufficient to prove the real effectiveness of these exercises in improving the performance of quadriceps muscle or assist in muscle balance of patellofemoral stabilizers.
髌骨股骨综合征(PDS)是一种以髌骨股骨疼痛和这种关节生物力学引起的物理变化为特征的疾病。发病率高,其病因尚不清楚。目的:本文献综述旨在比较开放式动力链运动与封闭式动力链运动对髌骨-股综合征患者功能恢复的效果。方法:在数据库LILACS、MEDLINE和PUB MED SCIELO中进行系统检索,检索词为髌骨综合征、开放动力链和封闭动力链。讨论:髌骨动力稳定器股内侧斜肌(VMO)和股外侧肌(VL)的力量不平衡仍然被认为是症状发生的主要因素。因为这种变化会增加反作用力和髌股压迫。为了恢复作为膝关节稳定剂的肌肉力量平衡,并作为恢复关节稳定性的一种手段,开放式动力链(OKC)和封闭式动力链(CKC)运动已被用于髌股疾病的康复计划。结论:实施这些协议的好处并没有得到很好的证明;科学证据不足以证明这些运动在改善股四头肌的表现或协助髌股稳定器的肌肉平衡方面的真正有效性。
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引用次数: 14
A rare cause of complete atrioventricular block: Lyme carditis 完全性房室传导阻滞的罕见病因:莱姆性心炎
Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20120203.02
M. Aydın, S. Bulur, Y. Türker, K. Süner, A. Şahin, H. Özhan
Lyme disease is a tick-borne spirochete infection that may affect the heart. Cardiac manifestations include conduction disturbances and other pathologies of the heart. Disturbance of atrioventricular (AV) node conduction is the most common cardiac manifestation of Lyme disease. We report a 61-year old female, who was admitted to the emergency de- partment with the complaints of syncope, dizziness and generalized fatigue. Physical examination revealed normal findings. The patient's electrocardiogram on admission revealed a newly diagnosed bradycardia due to third degree of AV block with40/min ventricular rate. The patient was admitted to the coronary care unit and was placed a transvenous pacemaker. Lyme serology and Western blot were positive for Borrelia antibodies. The symptoms and AV block resolved completely after doxycycline therapy.
莱姆病是一种可能影响心脏的蜱传螺旋体感染。心脏表现包括传导障碍和心脏的其他病理。房室结传导障碍是莱姆病最常见的心脏表现。我们报告一位61岁的女性,因晕厥、头晕和全身疲劳被送进急诊科。体检结果正常。患者入院时的心电图显示新诊断的心动过缓,原因是三度房室传导阻滞,心室速率为40/min。患者被送入冠状动脉监护室,并放置了经静脉起搏器。莱姆病血清学和Western blot检测伯氏疏螺旋体抗体阳性。多西环素治疗后症状和房室传导阻滞完全消失。
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引用次数: 1
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Clinical medicine and diagnostics
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